Trachs & Vents Flashcards
What is the function of the nose in the airway anatomy?
Filters dust and dirt
The nose acts as the first line of defense against particulate matter in the air.
What does the nasopharynx do?
Filters air, warms or cools air, humidifies air
The nasopharynx is crucial for preparing the air before it reaches the lungs.
What is the role of the oral pharynx?
Air passes through
The oral pharynx serves as a passageway for air to enter the respiratory system.
What is the structure and length of the trachea?
10-14cm (3.9”- 5.5”), composed of 15-20 C-shaped cartilaginous rings
The trachea bifurcates at the carina into left and right bronchi.
What is the general function of pulmonary function?
Exchange of gases
This is essential for maintaining oxygen and carbon dioxide levels in the body.
What occurs during inhalation?
Oxygen is taken into the blood and cells
Inhalation is the first part of the respiration cycle.
What occurs during exhalation?
Carbon dioxide is expelled from the cells and blood back to the atmosphere
This process completes the gas exchange cycle.
What is the pathway of air during respiration?
Trachea-bronchi-bronchioles-alveoli-blood stream (capillary walls-hemoglobin)
This pathway is essential for gas exchange.
Define breathing.
Physiological process of inhaling and exhaling
Breathing is a vital function for life.
What is the definition of respiration?
Process of gas exchange between an organism and its environment
This includes lungs, diaphragm, and respiratory muscles.
What is respiratory rate?
Breaths per minute
This is an important measure of respiratory health.
What is tidal volume?
The amount of air that moves in and out of the lungs on a respiratory cycle
Tidal volume is crucial for assessing lung function.
What is ventilation?
Mechanical movement of air into and out of the lungs in a cyclic fashion
This is the primary function of a ventilator.
What is a ventilator?
A medical device to maintain a stable respiratory rate and act as the primary respiratory pump
Ventilators are essential for patients with respiratory failure.
List the goals of mechanical ventilation.
- Relieve respiratory distress
- Rest respiratory musculature
- Decrease work of breathing
- Improve ventilation
- Improve oxygenation
- Prevent or reverse atelectasis
These goals help manage patients who cannot breathe adequately on their own.
What are the two options for respiratory support on the ventilator?
- Intubation via endotracheal tube
- Tracheostomy tube
Both methods are used for patients requiring prolonged respiratory support.
What is a tracheostomy?
Surgical procedure to create an opening in the trachea
Tracheostomy is often used for prolonged ventilation or airway obstruction.
What are the parts of a tracheostomy tube?
- Cuff
- Outer Cannula
- Inner Cannula
- Outer Flange
- Universal hub
- Pilot Balloon
Each part has a specific function in maintaining airway patency.
What are the types of tracheostomy tubes?
- Metal or plastic
- Cuffed or uncuffed
- Fenestrated or non-fenestrated
- Single lumen or double lumen
The choice of tube type depends on patient needs.
What is the function of the Passy-Muir Valve?
One-way speaking valve
It allows patients to speak while using a tracheostomy tube.
Who are candidates for speaking valves?
- Ventilator dependent patients
- Neuromuscular disease
- Head trauma
- Tetraplegia/Paraplegia
- CVA
- Chronic pulmonary disease
- Bronchopulmonary dysplasia
- Sleep apnea
- Mild tracheal/laryngeal stenosis
These patients benefit from improved communication and swallowing.
What are the clinical benefits of speaking valves?
- Communication
- Improves swallow
- May reduce aspiration
- Facilitates secretion management
- Improves oxygenation
- Improves olfaction
- Expedites weaning and decannulation
- Restores positive airway pressure
Speaking valves can significantly enhance the quality of life for patients with tracheostomies.
What are potential contraindications for the use of a speaking valve?
- Inflated cuff of the tracheostomy tube
- Foam-filled cuff
- Severe airway obstruction
- Unconscious or reduced cognition
- Unmanageable secretions
- Severe risk of aspiration
- Severely reduced lung elasticity
- Laryngectomee
- Bilateral vocal cord paralysis
- Do not use while patient is sleeping
These contraindications must be carefully considered before valve use.
What are the leading causes of death in the ICU?
- Multiorgan failure
- Cardiovascular failure
- Sepsis
These conditions account for a significant number of ICU fatalities.
What is the average ICU length of stay in the US?
Approximately 3.8 days
This reflects the acute nature of critical care treatment.
What types of patient monitoring are conducted in the ICU?
- Acute care physiologic monitoring system
- Pulse oximetry
- Intracranial pressure monitor
- Apnea monitor
- Cardiac monitors
Monitoring is crucial for managing critically ill patients.
What is the most common complication associated with endotracheal intubation?
Laryngeal injury
This can manifest as edema, subluxation, granulomas, and more.
What effects do tracheostomy and ventilation have on swallowing?
- Reduced laryngeal elevation and anterior movement
- Reduced airway closure
- Reduced positive subglottic air pressure
- Reduced pharyngeal/laryngeal sensation
- Restriction of cricopharyngeal sphincter opening
- Impingement on esophagus
- Inefficient/ineffective cough
- Reduced sensory awareness and coordination of respiration with swallow
These factors can significantly impair swallowing function.
What is the importance of early oral intake in severely impaired TBI patients?
Taste stimulation is an effective source of therapy and can help avoid further loss of swallow function, muscle atrophy, sensory deprivation, and nutritional deficiencies
Early oral intake is also less expensive than tube feeding.
